2005, 01-04 Permit App: 05000021 AdditionProject Number: 05000021 Inv: 1
Application
Date: 01/04/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Permit Use: BEDROOM & BATH ADDITION & 25 SQ FT COV Contact: THOMAS, TRAVIS D & BEA
PORCH
•
Setbacks: Front.Left: 15 Right: EX Rear: EX
Site Information:
Plat Key: 000000 Name: RANGE District: Nort
Address: 1303 N LILY RD
C - S - Z: SPOKANE VALLEY, WA 99212
Phone: (509) 926-0736
Group Name:
Project Name:
Parcel Number: 35131.0706
SiteAddress: 1303 N LILY RD
Location:: CSV
Block: Lot:
Owner: Name: THOMAS, TRAVIS D & BEA
Address: 1303 N LILY RD
SPOKANE VALLEY, WA 99212
Zoning: UR -3.5 Urban Residential 3.5
Water District: Hold: 0
Depth: 0 Right Of Way (ft): 0
Area: :,237.00 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review
Site Plan Review
Plan Review
Released By. 0C..)
1,..
1\(u,,t, (=t4i-tifrAEA--) (IT
eptic System Review
Released By.
Operator: K_C Printed By: K_C Print Date: 01/04/2005
Project Number: 05000021
Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 01/04/2005 Page 2 of 3
Contractor: OWNER
Total Area
Building Height
Stories
0
12.5
1
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Description Gtr Type Notes
CARPORT U-1 VB
RES ADD R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Item Description
VENTILATING FANS
Contractor: OWNER
Item Description
TOILETSBIDETS
SINKS
TUBS
This Application: Total Project:
Su Ft Valuation Su Ft Valuation
25 $375.00 25 $375.00
522 $38,982.96 522 $38,982.96
Totals: 547 $39,357.96
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
547 $39,357.96
Fee Amount
$542.75
$4.50
$217.10
$764.35
Finn: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Firm: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$10.00
$10.00
(000) 000-0000
Fee Amount
$6.00
$12.00
$6.00
$24.00
Operator: K_C Printed By: K_C Print Date: 01/04/2005
Project Number: 05000021 Inv: 1
Notes:
Application
Date: 01/04/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$764.35
$10.00
$24.00
$764.35
$10.00
$24.00
$798.35 $798.35
$0.00
$0.00
$0.00
$764.35
$10.00
$24.00
$0.00 $798.35
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: K_C Printed By: K_C Print Date: 01/04/2005
SO'lane
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
one: (509) 688-0036; Fax: (509) 688-0037
E�tUIItEd SI� INFORMATION
Street Address: 0 fV L,
Assessor's Tax Parcel Number(s): 35-1 ,,' 76)
Legal Description: ZA.v- k-. d
PERMIT DESCRIPTION: . � b wre) ,
5 Building Permit
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Lei / 95/1 - 6) -g -2 -
PD Owner:�>„� , ` s _5 ® Applicant: e_
Phone: 01'2i," -(2736 Fax: Phone: Fax:
Address: 1-;6.) 3 , L; I y Address:
'City fey w� . <>>z 12
City State Zip Code CityState Zip Code
❑ Contractor:
Phone: Fax:
Address:
City
State
WA State Contractor License #:
Zip Code
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: 1 , i
�
/FTG:--s,____
DIMENSIONS:
# OF STORIES:
l
MAIN FLOOR TO SQ. FTG:
211° FLOOR SQ. FTG:�=
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:I
TOTAL HABITABLE SPACE: /
IMPERVIOU&SURFACE AR ' :
COST OF PROJECT:
1ii(200
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? 5epf;c- cI-let-c .�y
Tho 5 e t-�ei--
'i n 2 GcE35
JAN 04 2005 11:08 FR
--deet, Number: 05000021 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
IU J241DbI r.u.'u.�
Date: 01/04/2005 Page 1 of 3
..,it Use: BEDROOM &
PernBAT1i ADDITION & 25 SQ FT COV Contact: THOMAS, TRAVIS D & BEA
PORCH Address: 1303 N LILY RD
C - S - Z: SPOKANE VALLEY, WA 99212
Setbacks: Front 311111 Left: 15 Right: EX Rear: EX Phone: (509) 926-0736
Group Name:
Project Name:
`frmation:
Plat Key: 000000 N: e: RANGE
Parcel Number: 35131 706
SiteAddress: 130 N LILY RD
Location:: CS\
Zoning: UR -3.
Water District
District: Nort
Block:
Urban Residential 3.5
Area: :,237.00 Acres Width: 0
Nbr of Bldgs: Nbr of Dwellings: 0
iew Fn ormation: .... .
Lot:
Owner: Name: THOMAS, TRAVIS D & BEA
Address: 1303 N LILY RD
SPOKANE VALLEY, WA 99212
Hold: E
Depth: 0 Right Of Way (ft): 0
Review
Site Plan Review
Plan Review
SepticSya�
Permits:
dr-e-zy, c-
Xtr,(T
Operator: K_C Printed By: K_C Print Date: 01/04/2005
//ce 0 /
I
SHARP RD,
SGAl ✓;
„to ;
�
m
w
co
Q
_
N
V
S.
N
M
pl
m
In
T�c9 uj th
I
SHARP RD,
SGAl ✓;
„to ;
�
m
w
co
Q
_
N
V
N
M
pl
m
In
T�c9 uj th
3-6 -79
rc ie Inc n. hl
9;�a-O;�-;lkD
N. 13o 3 L /'//Y
j'
1
ISO' Dryj'n p plgc,
wArER -- cdwP.
Pa w e r -- »
m
G
G
m
Z
cc
32JQ
ADDRESS
ZONE fiLSS`
ROADWIDTH
FRONT r i7 15 KING MI YL IS
COMMENTS
REVIEWED B mar 4/ 4
• (A.,)
$
12_6
C
'I I
r
1,:t ,
CL. Cck..
l0/
13R
TZv-
0
m
z
0' g